title: Pediatric neuro-oncology in small centers--quality control of network support: the HIT-GBM experience.
abstract: BACKGROUND
  The quality of care for children with brain tumors might be higher in large medical centers; however, it may be possible to improve the quality of care received in smaller centers if they join an effective network.
  
  
  OBJECTIVE
  This study used the HIT-GBM® database to compare the quality of care provided to pediatric high-grade glioma and diffuse intrinsic pontine glioma patients among various medical centers of differing sizes.
  
  
  METHODS
  Overall survival was used as a defining parameter. Indirect measures were the time intervals between the first clinical signs of cancer, initial diagnostic imaging, surgery, or chemotherapy and radiation.
  
  
  RESULTS
  From 1995 to 2003, 310 children (137 girls and 173 boys, aged 3 to 18 years old) were registered from 72 medical centers in Europe. Center sizes differed from 1 to 17 registered patients. Center size did not affect survival, nor any of the time intervals studied.
  
  
  CONCLUSIONS
  There was no evidence that the quality of care differed between smaller and larger centers.
authors.affiliation: Division of Pediatrics, MD Anderson Cancer Center, Houston, TX, USA. jwolff@tuftsmedicalcenter.org
authors.forename: Johannes E A
authors.initials: JE
authors.lastname: Wolff
authors.forename: Pablo Hernaiz
authors.initials: PH
authors.lastname: Driever
authors.forename: Birte
authors.initials: B
authors.lastname: Wolff
authors.forename: Christoph M
authors.initials: CM
authors.lastname: Kramm
authors.forename: Rolf-Dieter
authors.initials: RD
authors.lastname: Kortmann
authors.forename: Torsten
authors.initials: T
authors.lastname: Pietsch
authors.forename: Stefan
authors.initials: S
authors.lastname: Rutkowski
authors.forename: Astrid
authors.initials: A
authors.lastname: Gnekow
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000628:therapy*; D002173:Cancer Care Facilities / Q000458:organization & administration* / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D005910:Glioma / Q000628:therapy*; D006801:Humans; D008297:Male; D009462:Neurology / Q000592:standards; D010372:Pediatrics / Q000592:standards; D011786:Quality Control